Body satisfaction, thin-ideal internalization, and perceived pressure to be thin among Canadian women: The role of acculturation and religiosity

Altered effective connectivity between reward and inhibitory control networks in people with binge eating episodes: A spectral dynamic causal modeling study

BACKGROUND

Converging evidence points to the crucial role of brain connectivity involved in aberrant behavioral control and reward reactivity in the onset and maintenance of binge eating. However, the directional interaction pattern between brain's reward and inhibitory control systems in people with binge eating episodes is largely unknown.

METHODS

Resting-state fMRI data were collected from 36 adults with binge eating episodes (age: 19.05 ± 0.90) and 36 well-matched controls (age: 18.88 ± 0.78). We applied spectral dynamic causal modeling approach to estimate effective connectivity of the executive control network (ECN) and reward network (RN) with 15 predefined regions of interest, and investigate the between-group differences in directional connectivity.

RESULTS

Compared with controls, the positive connections within the ECN were significantly strengthened in individuals with binge eating episodes, while the negative connections from the ECN to RN and from the RN to ECN were significantly weakened. In adults with binge eating episodes, the RN→ECN connectivity was positively related to binge frequency even controlling for age, sex, and body mass index.

CONCLUSION

This study represents an important first step in addressing the role of directional integration between reward and inhibitory control networks in binge eating, and provides novel evidence that the ability of people with binge eating episodes to maintain a balance between inhibitory control and reward reactivity is decreased, as reflected by diminished bidirectional negative effects of prefrontal-subcortical circuitry at rest.

Association between high levels of body-esteem and increased degree of midcingulate cortex global connectivity: A resting-state fMRI study

Multiple neuroimaging studies have examined the neural underpinnings of body image disturbances in patients with eating disorders. However, key brain regions related to body image, such as body-esteem (BE), among healthy individuals are understudied. Given the extremely crucial role of BE in eating behaviors and physical and mental health, the current study conducted data-driven analysis and characterized the neurobiological correlates of BE with the network properties of the resting brain using the voxel-wise degree centrality (DC) measures of resting-state functional magnetic resonance imaging (rs-fMRI) data and seed-based resting-state functional connectivity (RSFC). A total of 694 healthy young adults (females = 474, mean age = 18.38 years, range = 17-22) underwent rs-fMRI, and completed the Body-Esteem Scale for Adolescents and Adults, the Eating Disorder Diagnosis Scale, and the Restraint Scale. After correcting for differences in age, gender, body mass index, and head motion, whole-brain correlation analyses revealed that a high level of BE was associated with increased DC within the right midcingulate cortex (MCC) and subsequent high levels of MCC-based RSFC strengths. Furthermore, MCC connectivity patterns related to BE were inversely associated with disordered eating behaviors. These findings suggest that adaptive cognitive and emotional regulation (i.e., self-evaluation and emotion based on body image) may explain the potential relationship between MCC connectivity patterns and BE to a certain extent. As such, future studies should investigate these interesting possibilities.

A qualitative exploration of motivations for fasting and the impact of Ramadan on eating behaviors and body image among young adult Muslim women in the United Kingdom

Research exploring the impact of fasting in Ramadan on eating behaviors has focused on Muslim-majority countries and has neglected to examine impacts beyond the month when "normal" eating patterns resume. This study aimed to explore the experiences of United Kingdom-residing young adult Muslim women who were fasting in Ramadan to understand its impact on their body image and eating behaviors both during and 1-month following Ramadan. In-depth, semi-structured interviews were conducted with 14 Muslim women aged between 18 and 35 (Mage = 27.3) at two distinct time-points: during the last week of Ramadan and 1-2 months later. The interviews explored questions related to motivations for fasting, experience of fasting in Ramadan, and eating behaviors and thoughts related to body image and appearance. Thematic Analysis revealed three themes: (1) family and community expectations to fast (2) exertion of control of on eating behaviors and (3) preoccupation with weight and appearance. The results suggest that family and community play a strong role in motivating women to fast during Ramadan, alongside the need to feel a sense of belonging to their community. This can conflict with the pressure and desire to assimilate with Western culture and associated appearance ideals, thus putting women at greater risk of disordered eating and body image concerns. These findings suggest important implications for increased support in the Muslim community, and the need for further research to explore this topic across longer time-points and in different cultural groups.

Exploring Determinants of Sexual Satisfaction in a Chilean Representative Sample

This article examines the relationship between sexual satisfaction and gender, age, social status, being in stable relationships, intercourse frequency, and satisfaction with physical attractiveness (physical appearance and sex appeal). A self-report questionnaire was applied in a representative sample of 767 residents of Santiago (Chile), over 18 years old and that have had, at least, one sexual relation (with penetration) during their lives. Higher sexual satisfaction was predicted negatively by age and positively by higher satisfaction with sex appeal, higher intercourse frequency and having a stable relationship. Among women, the principal predictors are satisfaction with sex appeal and intercourse frequency. Among men to the above, it is necessary to add satisfaction with physical appearance and having a stable relationship - at odds with supposed higher relevance for women of body satisfaction and sensibility to social relationships. Discussion emphasizes the controversial nature of the gender differences found regarding the Latin American culture.

Body image among Muslim women in Israel: exploring religion and sociocultural pressures

The study aimed to investigate the association of the Muslim religion, as a multidimensional factor, with social pressures related to body image concerns, among Muslim women in Israel. Four hundred and Seventy-five Israeli Muslim women ages between 18 and 30 years completed questionnaire measures of strength of religious faith, wearing a traditional head cover (the Hijab), positive and negative body image, media exposure, societal pressures to conform to Western body ideals and its internalization, from 2016 to 2018. Strength of religious faith and wearing the Hijab were positively associated with positive aspects of body image, while only strength of religious faith negatively correlated with body dissatisfaction. Further, mediation analyses revealed that the relationship between the strength of religious faith and both positive body image and body dissatisfaction was mediated by media pressures. Notably, reduced peer pressures had more influence on positive body image, while reduced family pressures were more influential for negative body image. These results are discussed with regard to promoting a more intricate and multicultural understanding of body image concepts.

Facebook, body esteem, and body surveillance in adult women: The moderating role of self-compassion and appearance-contingent self-worth

This study examined how Facebook use and specific Facebook activities were associated with body esteem and body surveillance in adult women. This study also examined whether self-compassion and appearance-contingent self-worth moderated the relationship between Facebook appearance comparison and body esteem, and the relationship between Facebook appearance comparison and body surveillance. Self-report measures were administered to adult women (N = 232) between the ages of 20 and 72 (M = 35.91) recruited through MTurk. Results indicated that Facebook appearance-exposure and Facebook appearance comparison significantly related to body surveillance, whereas only Facebook appearance comparison significantly related to body esteem. Overall Facebook use and Facebook intensity were not significantly associated with either body esteem or body surveillance. Self-compassion and appearance-contingent self-worth significantly related to body esteem and body surveillance. However, neither self-compassion nor appearance-contingent self-worth significantly moderated the relationship between Facebook appearance comparison and body surveillance. Similarly, a lack of significant moderation was found for the relationship between Facebook appearance comparison and body esteem. The importance of studying body image and Facebook activities in adult women is discussed. Additionally, the importance for researchers to examine how specific Facebook activities, beyond Facebook use, are linked with body image in this population is also highlighted.

Thin Media Images Decrease Women's Body Satisfaction: Comparisons Between Veiled Muslim Women, Christian Women and Atheist Women Regarding Trait and State Body Image

Research in diverse populations has often found that thin media images negatively affect women’s state body image, with many women reporting lower body satisfaction after exposure to pictures of thin models than before exposure. However, there is evidence that theistic affirmations might buffer against the negative effect of media on body image. Furthermore, religiosity and the Islamic body covering are discussed as protective factors against a negative trait body image. However, there is no experimental research on veiled Muslim women’s state body image. Therefore, the current study experimentally investigated whether the body satisfaction of veiled Muslim women (n = 66) decreased after exposure to thin media images compared to pictures of furniture as a control condition. Christian women (n = 90) and atheist women (n = 74) were included as control groups, and participants were randomly assigned to the two conditions. Prior to the experimental session, participants’ trait body image was assessed using an online questionnaire comprising questions about body satisfaction, thin-ideal internalization, pressure to be thin, and physical appearance comparisons. It was found that veiled Muslim women had a more positive trait body image than did Christian women and atheist women. Accordingly, veiled Muslim women reported lower levels of thin-ideal internalization, pressure to be thin, and physical appearance comparisons than did Christian women and atheist women. The experimental findings showed that body satisfaction decreased in the experimental condition and not in the control condition, but no significant differences in pre-post changes emerged between the three groups. As the pre-post changes in body satisfaction did not differ between the three groups, veiling might not buffer against the negative effect of thin media images on state body image. Nevertheless, given the more positive trait body image of veiled Muslim women compared to Christian and atheist women, veiling might positively influence body image in the longer term. However, as additional analyses including unveiled Muslim women did not reveal differences between veiled and unveiled Muslim women, future studies should test the assumption that affiliation to Islam might be more decisive for a positive trait body image than veiling.

Body Covering and Body Image: A Comparison of Veiled and Unveiled Muslim Women, Christian Women, and Atheist Women Regarding Body Checking, Body Dissatisfaction, and Eating Disorder Symptoms

Although Islam is the fastest growing religion worldwide, only few studies have investigated body image in Muslim women, and no study has investigated body checking. Therefore, the present study examined whether body image, body checking, and disordered eating differ between veiled and unveiled Muslim women, Christian women, and atheist women. While the groups did not differ regarding body dissatisfaction, unveiled Muslim women reported more checking than veiled Muslim and Christian women, and higher bulimia scores than Christian. Thus, prevention against eating disorders should integrate all women, irrespective of religious affiliation or veiling, with a particular focus on unveiled Muslim women.

Introducing the Body-QoL®: A New Patient-Reported Outcome Instrument for Measuring Body Satisfaction-Related Quality of Life in Aesthetic and Post-bariatric Body Contouring Patients

OBJECTIVE

To develop a new patient-reported outcome instrument (PRO) to measure body-related satisfaction quality of life (QoL).

METHODS

Standard 3-phase PRO design was followed; in the first phase, a qualitative design was used in 45 patients to develop a conceptual framework and to create preliminary scale domains and items. In phase 2, large-scale population testing on 1340 subjects was performed to reduce items and domains. In phase 3, final testing of the developed instrument on 34 patients was performed. Statistics used include Factor, RASCH, and multivariate regression analysis. Psychometric properties measured were internal reliability, item-rest, item-test, and test-retest correlations.

RESULTS

The PRO-developed instrument is composed of four domains (satisfaction with the abdomen, sex life, self-esteem and social life, and physical symptoms) and 20 items in total. The score can range from 20 (worst) to 100 (best). Responsiveness was 100 %, internal reliability 93.3 %, and test-retest concordance 97.7 %. Body image-related QoL was superior in men than women (p < 0.001) and decreased with increasing age (p = 0.004) and BMI (p < 0.001). Post-bariatric body contouring patients score lower than cosmetic patients in all domains of the Body-QoL instrument (p < 0.001). After surgery, the score improves by on average 21.9 ± 16.9 (effect size 1.8, p < 0.001).

CONCLUSIONS

Body satisfaction-related QoL can be measured reliably with the Body-QoL instrument. It can be used to quantify the improvement in cosmetic and post-bariatric patients including non- or minimally invasive procedures, suction assisted lipectomy, abdominoplasty, lipoabdominoplasty, and lower body lift and to give an evidence-based approach to standard practice.

LEVEL OF EVIDENCE I

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Body image and appearance perceptions from immigrant adolescents in Canada: An interpretive description

Body dissatisfaction has been linked to a number of poor health outcomes, including eating disorders. However, very few studies have investigated body dissatisfaction among immigrant adolescents. Using inductive qualitative inquiry, this study recruited a purposeful sample of immigrant adolescents (N=18, 78% female) with an eating disorder (n=8) and without an eating disorder (n=10). All adolescents were between 16 and 19 years of age (M=16.80, SD=0.89) and were recruited from three municipalities in Ontario. Each adolescent participated in a face-to-face, qualitative interview. Content analysis revealed descriptions of body image that were similar across the sample. The main themes emerging from this work include (a) the "moderately slim" and "moderately muscular" ideal, (b) the "slim and curvy paradox," (c) "ideal" privilege, (d) having an "expected" appearance, and (e) wishful comparisons. Findings have implications for reducing appearance-related dissatisfaction among immigrant adolescents in Canada.